The only challenge that 60-year-old avid golfer Bill Slavin faces now is reducing his handicap out on the greens. Before his total knee replacement surgery at UCSF Medical Center in July 2005, Slavin's handicap was far more serious: a college football injury damaged his right knee and cramped his ability to lead an active life.
"My knee became a disability that I had to cope with and I resigned myself to the fact that I was going to be a cripple," says Slavin. "I was enduring a high level of pain that I had to live with all of the time."
After Slavin's initial knee injury during college, the torn cartilage, also known as the meniscus, which normally cushions the ends of the bones and allows for easy movement, was surgically removed in his right knee. As a result of the surgery, Slavin developed severe osteoarthritis, a common type of arthritis in which the knee's cartilage breaks down, causing the knee bones to rub against each other. He experienced severe and persistent pain and his right leg shortened and developed a bowlegged stance.
Slavin, who worked as an international management consultant for 40 years, periodically visited a doctor in Danville, Calif. for his knee condition. And although his pain was severe and greatly impacted his quality of life, Slavin resisted surgery.
"I avoided surgery for years because I was so busy with work and didn't think I had the time to recover," says Slavin, who retired before his surgery in July 2005. "Also, I really did not believe that I would be any better off after surgery than before."
Eventually, Slavin's osteoarthritis in his knee impacted other parts of his body. He began experiencing pain in his hips and back, which were likely compensating for his weak knees. And after years of taking over-the-counter painkillers to ease the pain in his knees, he also developed ulcers.
Slavin's doctor referred him to UCSF's Orthopedic Arthroplasty Service that specializes in joint replacement surgery and offers the latest advancements in this procedure many of which aren't available at other medical centers. Slavin was treated by Dr. Kevin Bozic, an orthopedic surgeon who is an expert in hip and knee replacement with an emphasis in minimally invasive techniques.
After carefully evaluating Slavin's health and diagnosing his condition, Bozic recommended a total knee replacement. It's a common surgery in which the damaged bone surfaces and cartilage are removed and replaced with artificial surfaces made of metal and plastic material, called "implants" or "prostheses," which restore the alignment and function of the knee.
"I was still skeptical about having surgery," admits Slavin, "but Dr. Bozic carefully explained the procedure by showing me my X-rays on the computer and how he would correct my knee and straighten my leg. I felt as though I was participating in the surgery."
Before his knee replacement, Slavin attended a pre-surgery briefing where the procedure and recovery was explained and he had a chance to ask any questions, which he says greatly reduced his fears and anxieties.
During Slavin's knee replacement surgery, Bozic used special cameras and advanced intra-operative imaging tools that projected images of the area being operated onto a television screen. On-screen prompts helped guide Bozic to the ideal alignment of Slavin's implant and provided real-time vision of the surgical site. This high-precision alignment extends the long-term survival of the implanted artificial hip or knee, thus reducing the need for future corrective surgeries.
"When I first saw Bill, it was clear that the arthritis in his knee was causing severe pain and significantly impacting his quality of life," says Bozic. "After we discussed the pros and cons of various treatment options, he elected to have total knee replacement surgery. I agreed with his decision since I knew the operation would alleviate his pain and allow him to return to a healthy and active lifestyle."
After surgery, Slavin was committed to rebuilding the muscles in his right leg to help his knee recover with regular physical therapy and exercise. "Knee replacement is a serious operation with serious recovery, but if you apply yourself and exercise and work to rebuild your muscles, you will have amazing results," says Slavin, who was able to walk the second day after surgery. And three months later, he won his first golf tournament. Now, Slavin regularly hits the links, takes power walks with his wife and rides his bike 90 miles each week. The only downside, he jokes, is that he no longer gets any sympathy on the golf course.
"The surgery has had a major impact on my life and improved my outlook so that I am highly motivated to be physically active," says Slavin, whose latest goal is to ride 100 miles on his bike. "For anyone who is experiencing knee pain, I strongly suggest that they investigate what can be done for them because there are amazing therapies available."
Story written in May 2006
Abby Sinnott is a freelance writer in San Francisco.